How effective is neurodevelopmental therapy in kids with cerebral palsy?

When it comes to treating children with cerebral palsy (CP), neurodevelopmental therapy (NDT) appears to produce smaller improvements in motor function compared with activity-based and body structure and function interventions, according to a study. Furthermore, NDT is no better than control, and higher-dose is not more effective than lower-dose NDT.

Researchers performed a systematic review and meta-analysis of randomized controlled trials comparing the efficacy of NDT against any or no intervention in children and infants with CP or at high risk of CP. They searched multiple online databases and identified 667 articles.

Meta-analysis was carried out with standardized mean differences calculated. Quality was evaluated using Cochrane Risk of Bias tool-2, while certainty was measured by using Grading of Recommendations Assessment, Development, and Evaluation.

A total of 34 studies, which involved a total of 1,332 participants, were included in the meta-analyses. Pooled data showed no significant difference between NDT and control (effect size, 0.13, 95 percent confidence interval [CI], −0.20 to 0.46) and a moderate effect favouring activity-based approaches (effect size, 0.76, 95 percent CI, 0.12 to 1.40]) and body function and structures (effect size, 0.77, 95 percent CI, 0.19 to 1.35) over NDT.

Finally, there was no significant difference between higher- and lower-dose NDT (effect size, 0.32, 95 percent CI, −0.11 to 0.75).

Based on the data, the researchers strongly recommended against the use of NDT at any dose in children with cerebral palsy.

Not all studies were Consolidated Standards of Reporting Trials-compliant. NDT vs activity-based comparator showed considerable heterogeneity (I², 80 percent), having varied measures.